Utilisation de la glycorachie et de la protéinorachie comme marqueurs prédictifs des résultats de la culture du liquide céphalorachidien.

Abstract

Central nervous system (CNS) infections, particularly meningitis, represent a medical emergency due to their rapid progression and severity. Their diagnosis is mainly based on cerebrospinal fluid (CSF) analysis, which allows the detection of infectious agents as well as the associated biochemical and cytological alterations. This study aims to evaluate the diagnostic value of biochemical and bacteriological investigations of cerebrospinal fluid in CNS infections. It included 115 CSF samples collected from 54 males and 61 females. The performed analyses included macroscopic examination, cytological study after Gram and May-Grünwald-Giemsa (MGG) staining, culture on appropriate media followed by macroscopic, microscopic, and biochemical identification, as well as measurement of CSF glucose (glycorrhachia) and protein levels (proteinorrhachia) using an automated method (Mindray BS-240) and a manual method (Trinder). The results showed 20 positive culture cases, with a slight male predominance (55%) compared with females (45%), while a female predominance was observed in the age group from 1 day to 9 years. Biochemically, 75% of positive cases were associated with hypoglycorrhachia (<0.5 g/L), and all cases showed hyperproteinorrhachia (>0.45 g/L). Linear discriminant analysis (LDA) revealed that CSF protein level was the most predictive parameter of a positive culture compared with CSF glucose level. These results confirm the importance of CSF biochemical analysis, particularly protein measurement, as a key marker for the diagnostic orientation of bacterial meningitis, in combination with conventional cytological and bacteriological investigations.